Canterbury DHB

Context

Bone and Joint

In This Section

Acute Osteomyelitis and Septic Arthritis

Acute Osteomyelitis and Septic Arthritis

Pathogens

Drug Treatment

Empiric

Non-vertebral osteomyelitis and septic arthritis

flucloxacillin

HMLSchedNZFPMLnoids

IV 2 g every six hours

If risk factors for MRSA, add:

vancomycin

HMLSchedNZFPMLnoids

See dosing guidelines.

Mild penicillin allergy

cefazolin

HMLSchedNZFPMLnoids

IV 2 g every eight hours

If risk factors for MRSA, add:

vancomycin

HMLSchedNZFPMLnoids

See dosing guidelines.

Severe penicillin allergy

vancomycin

HMLSchedNZFPMLnoids

See dosing guidelines.

Vertebral osteomyelitis

Consult Infectious Diseases/Clinical Microbiology.

Pathogens Known

S. aureus

Methicillin susceptible S. aureus (MSSA)

See empiric treatment.

Methicillin resistant S. aureus (MRSA)

vancomycin

HMLSchedNZFPMLnoids

See dosing guidelines.

Streptococcus (Note: check susceptibility)

benzylpenicillin

HMLSchedNZFPMLnoids

(Penicillin G)

IV 1.8 g (3 megaunits) every four hours

Mild penicillin allergy (Note: check susceptibility)

cefazolin

HMLSchedNZFPMLnoids

IV 2 g every eight hours

Severe penicillin allergy (Note: check susceptibility)

vancomycin

HMLSchedNZFPMLnoids

See dosing guidelines.

Enterobacteriaceae (mainly coliforms)

Treat according to known or local susceptibilities.

Pseudomonas aeruginosa (suspect if penetrating foot injury through a shoe)

Consult Infectious Diseases/Clinical Microbiology.

Information about this Canterbury DHB document (99210):

Document Owner:

Not assigned (see Who's Who)

Last Updated:

March 2018 (Bone and Joint)

Next Review Due:

March 2021

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document.

Topic Code: 99210